Daratumumab side effects: what 17,980 FDA adverse event reports show
Drug class
CD38-directed Cytolytic Antibody, Endoglycosidase
Label matched
Daratumumab And Hyaluronidase-Fihj (Human Recombinant) (Darzalex Faspro)
Who reports
17,980 reports · 94% serious · 2,666 with death outcome · 42% female
Used for
DARZALEX FASPRO is a combination of daratumumab, a CD38-directed cytolytic antibody, and hyaluronidase, an endoglycosidase, indicated for the treatment of adult patients with: multiple myeloma in combination with bortezomib, lenalidomide, and dexametha.
What it is
Daratumumab is an immunoglobulin G1 kappa (IgG1κ) human monoclonal antibody that binds to the CD38 antigen. Daratumumab is produced in Chinese Hamster Ovary (CHO) cells using recombinant DNA technology.
Boxed warning
None in the current label
Causality screen of the 40 strongest signals
What the badges mean
- Labeled adverse reaction The exact term appears in the label's warnings or adverse-reactions sections: a known, expected effect. The FAERS signal confirms the label rather than discovering anything.
- Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
- Likely indication confounding The term appears in the label's indications: reports probably describe the disease being treated (or its progression), not a drug effect. Classic confounding by indication.
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Lab value / disease marker A laboratory result, investigation or disease-activity marker (antibody positive, CRP abnormal, swollen joint count) not described in the label. These usually mirror the monitored disease or testing protocol rather than a drug effect; not screened further.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,089 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Crossmatch incompatible | 45 | 1,231.6 720.5–2,105.3ROR 1,233.0 · calibrated p 2e-16 ✓ | 316.9 EB05 246.6 · IC025 +5.7 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Coombs indirect test positive | 35 | 466.7 295.7–736.5ROR 467.1 · calibrated p 2e-12 ✓ | 217.3 EB05 163.3 · IC025 +5.2 3/3 methods agree | Lab value / disease marker | not fetched | no trial data cached |
| Blood stem cell harvest | 15 | 354.5 183.9–683.4ROR 354.7 · calibrated p 2e-10 ✓ | 166.8 EB05 107.3 · IC025 +3.9 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Plasma cell myeloma refractory | 498 | 331.6 296.5–370.9ROR 335.8 · calibrated p 4e-12 ✓ | 201.3 EB05 186.9 · IC025 +7.3 3/3 methods agree | Labeled (related wording) related wording | not fetched | no trial data cached |
| Autologous haematopoietic stem cell transplant | 25 | 209.7 131.8–333.6ROR 209.8 · calibrated p 2e-9 ✓ | 134.5 EB05 95.8 · IC025 +4.6 3/3 methods agree | Labeled (related wording) related wording | not fetched | no trial data cached |
| Pseudomyopia | 28 | 171.3 111.8–262.5ROR 171.4 · calibrated p 7e-9 ✓ | 118.8 EB05 86.3 · IC025 +4.7 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Light chain disease | 28 | 124.4 82.4–187.9ROR 124.5 · calibrated p 7e-8 ✓ | 94.3 EB05 68.5 · IC025 +4.6 3/3 methods agree | Likely indication confounding term in indications; also in warnings | not fetched | no trial data cached |
| Primary amyloidosis | 46 | 117.3 85.2–161.4ROR 117.4 · calibrated p 7e-8 ✓ | 92.3 EB05 72.0 · IC025 +5.1 3/3 methods agree | Likely indication confounding term in indications; also in warnings | not fetched | no trial data cached |
| Natural killer cell count decreased | 16 | 112.4 65.5–193.0ROR 112.5 · calibrated p 3e-7 ✓ | 83.7 EB05 54.6 · IC025 +3.8 3/3 methods agree | Lab value / disease marker | not fetched | no trial data cached |
| Plasma cell leukaemia | 104 | 111.0 89.9–137.2ROR 111.3 · calibrated p 7e-8 ✓ | 90.2 EB05 76.6 · IC025 +5.7 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Monoclonal immunoglobulin increased | 42 | 92.2 66.4–127.9ROR 92.2 · calibrated p 4e-7 ✓ | 75.8 EB05 58.5 · IC025 +4.8 3/3 methods agree | Lab value / disease marker | not fetched | no trial data cached |
| Metapneumovirus pneumonia | 13 | 85.6 47.6–153.8ROR 85.6 · calibrated p 2e-6 ✓ | 66.7 EB05 41.5 · IC025 +3.4 3/3 methods agree | Labeled (related wording) related wording | not fetched | no trial data cached |
| Aspiration bone marrow | 18 | 81.4 49.5–133.8ROR 81.4 · calibrated p 2e-6 ✓ | 65.8 EB05 44.0 · IC025 +3.8 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Blood stem cell harvest failure | 19 | 77.2 47.7–125.0ROR 77.2 · calibrated p 3e-6 ✓ | 63.3 EB05 42.8 · IC025 +3.9 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Plasmacytoma | 237 | 76.2 66.5–87.3ROR 76.7 · calibrated p 9e-7 ✓ | 66.3 EB05 59.5 · IC025 +5.7 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Prohormone brain natriuretic peptide increased | 12 | 76.1 41.5–139.5ROR 76.1 · calibrated p 6e-6 ✓ | 60.4 EB05 36.8 · IC025 +3.2 3/3 methods agree | Lab value / disease marker | not fetched | no trial data cached |
| Light chain analysis abnormal | 25 | 72.6 47.8–110.4ROR 72.7 · calibrated p 3e-6 ✓ | 61.0 EB05 43.5 · IC025 +4.2 3/3 methods agree | Reporting / coding artifact | not fetched | no trial data cached |
| Light chain analysis increased | 121 | 70.5 58.4–85.3ROR 70.8 · calibrated p 2e-6 ✓ | 61.7 EB05 53.0 · IC025 +5.3 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Acute myopia | 18 | 62.0 38.0–101.0ROR 62.0 · calibrated p 1e-5 ✓ | 52.6 EB05 35.2 · IC025 +3.7 3/3 methods agree | Labeled adverse reaction exact term | not fetched | no trial data cached |
| Plasma cell myeloma recurrent | 340 | 61.2 54.8–68.5ROR 61.8 · calibrated p 4e-6 ✓ | 54.7 EB05 50.0 · IC025 +5.5 3/3 methods agree | Likely indication confounding shares a disease stem with the indications wording | not fetched | no trial data cached |
| Plasma cell myeloma | 3,892 | 58.3 56.5–60.2ROR 64.6 · calibrated p 3e-6 ✓ | 52.5 EB05 51.2 · IC025 +5.7 3/3 methods agree | Likely indication confounding shares a disease stem with the indications wording | not fetched | no trial data cached |
| Monoclonal immunoglobulin present | 68 | 51.5 40.1–66.0ROR 51.6 · calibrated p 1e-5 ✓ | 46.4 EB05 37.8 · IC025 +4.7 3/3 methods agree | Lab value / disease marker | not fetched | no trial data cached |
| Meningitis listeria | 43 | 48.4 35.4–66.1ROR 48.4 · calibrated p 3e-5 ✓ | 43.6 EB05 33.7 · IC025 +4.4 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Stem cell transplant | 189 | 43.6 37.6–50.6ROR 43.8 · calibrated p 3e-5 ✓ | 40.2 EB05 35.6 · IC025 +5.0 3/3 methods agree | Likely indication confounding term in indications; also in warnings | not fetched | no trial data cached |
| Listeria sepsis | 20 | 42.8 27.1–67.5ROR 42.8 · calibrated p 8e-5 ✓ | 38.3 EB05 26.2 · IC025 +3.6 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Refractory cancer | 14 | 36.4 21.2–62.6ROR 36.4 · calibrated p 2e-4 ✓ | 32.7 EB05 20.7 · IC025 +3.1 3/3 methods agree | Likely indication confounding shares a disease stem with the indications wording | not fetched | no trial data cached |
| Plasmablastic lymphoma | 23 | 36.4 23.8–55.5ROR 36.4 · calibrated p 2e-4 ✓ | 33.2 EB05 23.3 · IC025 +3.6 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Paraproteinaemia | 19 | 34.1 21.4–54.2ROR 34.1 · calibrated p 3e-4 ✓ | 31.1 EB05 21.1 · IC025 +3.4 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Morganella infection | 17 | 32.4 19.8–52.8ROR 32.4 · calibrated p 4e-4 ✓ | 29.6 EB05 19.6 · IC025 +3.2 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Blood immunoglobulin a decreased | 36 | 30.8 22.0–43.2ROR 30.9 · calibrated p 3e-4 ✓ | 28.8 EB05 21.7 · IC025 +3.8 3/3 methods agree | Lab value / disease marker | not fetched | no trial data cached |
| Disseminated varicella zoster virus infection | 19 | 30.0 18.9–47.7ROR 30.0 · calibrated p 5e-4 ✓ | 27.7 EB05 18.8 · IC025 +3.3 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Renal amyloidosis | 13 | 29.5 16.9–51.6ROR 29.5 · calibrated p 7e-4 ✓ | 27.0 EB05 16.7 · IC025 +2.9 3/3 methods agree | Labeled (related wording) related wording | not fetched | no trial data cached |
| Osteolysis | 108 | 29.3 24.2–35.6ROR 29.4 · calibrated p 3e-4 ✓ | 27.7 EB05 23.6 · IC025 +4.3 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Body dysmorphic disorder | 19 | 28.4 17.9–45.0ROR 28.4 · calibrated p 7e-4 ✓ | 26.3 EB05 17.8 · IC025 +3.2 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Cardiac amyloidosis | 55 | 28.1 21.4–36.8ROR 28.1 · calibrated p 5e-4 ✓ | 26.5 EB05 21.1 · IC025 +4.0 3/3 methods agree | Likely indication confounding term in indications; also in warnings | not fetched | no trial data cached |
| Hypogammaglobulinaemia | 317 | 27.4 24.5–30.7ROR 27.6 · calibrated p 4e-4 ✓ | 26.1 EB05 23.7 · IC025 +4.5 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Visceral leishmaniasis | 34 | 26.3 18.6–37.1ROR 26.3 · calibrated p 7e-4 ✓ | 24.8 EB05 18.5 · IC025 +3.6 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Enterocolitis bacterial | 13 | 26.0 14.9–45.4ROR 26.0 · calibrated p 0.001 ✓ | 24.0 EB05 14.7 · IC025 +2.8 3/3 methods agree | Not in label — unassessed | not fetched | no trial data cached |
| Transplant | 109 | 25.3 20.9–30.7ROR 25.4 · calibrated p 7e-4 ✓ | 24.1 EB05 20.6 · IC025 +4.1 3/3 methods agree | Likely indication confounding term in indications; also in warnings | not fetched | no trial data cached |
| Coombs direct test positive | 14 | 24.8 14.5–42.5ROR 24.9 · calibrated p 0.001 ✓ | 23.0 EB05 14.4 · IC025 +2.8 3/3 methods agree | Lab value / disease marker | not fetched | no trial data cached |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Plasma cell myeloma | 3,892 | 58.3 56.5–60.2ROR 64.6 · calibrated p 3e-6 ✓ | 52.5 EB05 51.2 · IC025 +5.7 3/3 methods agree | Likely indication confounding shares a disease stem with the indications wording | not fetched | no trial data cached |
| Off label use (used outside approved label) | 3,550 | 2.2 2.1–2.2ROR 2.3 · calibrated p 0.913 | 2.2 EB05 2.1 · IC025 +1.1 3/3 methods agree | Reporting / coding artifact | not fetched | no trial data cached |
| Infusion related reaction (reaction during infusion) | 2,649 | 22.0 21.2–22.9ROR 23.5 · calibrated p 9e-4 ✓ | 21.2 EB05 20.5 · IC025 +4.3 3/3 methods agree | Labeled (related wording) related wording | not fetched | no trial data cached |
| Pneumonia (lung infection) | 2,037 | 3.3 3.2–3.5ROR 3.5 · calibrated p 0.492 | 3.3 EB05 3.2 · IC025 +1.7 3/3 methods agree | Labeled adverse reaction exact term | not fetched | no trial data cached |
| Neutropenia (low neutrophils (infection-fighting cells)) | 2,018 | 8.0 7.6–8.3ROR 8.3 · calibrated p 0.058 | 7.9 EB05 7.6 · IC025 +2.9 3/3 methods agree | Labeled adverse reaction exact term | not fetched | no trial data cached |
| Fatigue (tiredness) | 1,765 | 1.2 1.1–1.3ROR 1.2 · calibrated p 0.446 | 1.2 EB05 1.2 · IC025 +0.2 | Labeled adverse reaction exact term | not fetched | no trial data cached |
| Diarrhoea (diarrhea) | 1,739 | 1.4 1.4–1.5ROR 1.4 · calibrated p 0.608 | 1.4 EB05 1.4 · IC025 +0.4 | Labeled adverse reaction exact term | not fetched | no trial data cached |
| Drug ineffective (drug did not work) | 1,586 | 0.6 0.6–0.7ROR 0.6 · calibrated p 0.093 | 0.6 EB05 0.6 · IC025 -0.7 PRR-only: not supported by EBGM or IC | Reporting / coding artifact | not fetched | no trial data cached |
| Neuropathy peripheral (nerve damage in hands/feet) | 1,471 | 8.3 7.9–8.8ROR 8.6 · calibrated p 0.053 | 8.2 EB05 7.9 · IC025 +2.9 3/3 methods agree | Labeled adverse reaction exact term | not fetched | no trial data cached |
| Death | 1,468 | 0.9 0.9–0.9ROR 0.9 · calibrated p 0.241 | 0.9 EB05 0.9 · IC025 -0.2 PRR-only: not supported by EBGM or IC | Outcome field, not a reaction | not fetched | no trial data cached |
| Thrombocytopenia (low platelets) | 1,416 | 6.8 6.4–7.1ROR 7.0 · calibrated p 0.099 | 6.7 EB05 6.4 · IC025 +2.7 3/3 methods agree | Labeled adverse reaction exact term | not fetched | no trial data cached |
| Pyrexia (fever) | 1,315 | 2.0 1.9–2.1ROR 2.0 · calibrated p 0.968 | 2.0 EB05 1.9 · IC025 +0.9 | Labeled adverse reaction exact term | not fetched | no trial data cached |
| Dyspnoea (shortness of breath) | 1,313 | 1.2 1.2–1.3ROR 1.2 · calibrated p 0.463 | 1.2 EB05 1.2 · IC025 +0.2 | Labeled adverse reaction exact term | not fetched | no trial data cached |
| Anaemia (low red blood cells) | 1,216 | 3.4 3.2–3.6ROR 3.5 · calibrated p 0.496 | 3.4 EB05 3.2 · IC025 +1.7 3/3 methods agree | Labeled adverse reaction exact term | not fetched | no trial data cached |
| Nausea | 1,126 | 0.8 0.7–0.8ROR 0.7 · calibrated p 0.154 | 0.8 EB05 0.7 · IC025 -0.5 PRR-only: not supported by EBGM or IC | Labeled adverse reaction exact term | not fetched | no trial data cached |
Unlabeled candidate signals
These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.
- Crossmatch incompatible — n=45, PRR 1,231.6
- Pseudomyopia — n=28, PRR 171.3
- Plasma cell leukaemia — n=104, PRR 111.0
- Plasmacytoma — n=237, PRR 76.2
- Light chain analysis increased — n=121, PRR 70.5
- Meningitis listeria — n=43, PRR 48.4
- Listeria sepsis — n=20, PRR 42.8
- Plasmablastic lymphoma — n=23, PRR 36.4
- Osteolysis — n=108, PRR 29.3
- Hypogammaglobulinaemia — n=317, PRR 27.4
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Daratumumab?
In FDA FAERS, the most frequently co-reported reaction terms for Daratumumab are plasma cell myeloma, infusion related reaction, pneumonia, neutropenia, fatigue, diarrhoea. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Daratumumab have an FDA boxed warning?
No. The FDA label retrieved for Daratumumab has no boxed warning; see the label's Warnings and Precautions for the recognised risks.
Do FAERS signals prove that Daratumumab causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID 4bb241af-4299-4373-8762-2d6709515db0, effective 20260903; matched on
openfda.generic_name:"DARATUMUMAB") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 1,129 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath
Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.